目的 评估外科重症监护室（surgical intensive care unit, SICU）非机械通气老年患者术后的睡眠质量和睡眠结构。 方法 采用澳大利亚生产的Compumedics Siesta多导睡眠图（polysomnography, PSG）监测系统，分析50例SICU术后当晚的非机械通气老年患者（病例组）和40例非手术的老年体检者（对照组）的PSG。 结果 与对照组比较，病例组的术后睡眠总时间减少［289.5 min（147.5~398.8 min）比218.4 min（125.3~345.7 min） ］（P<0.05），睡眠效率低［48.2%（24.6%~66.5%）比36.3%（20.8%~57.6%）］（P<0.05）；病例组术后睡眠以1期睡眠为主［67.3%（21.6%~78.3%）］，对照组睡眠以2期睡眠为主［59.6%（18.2%~73.2%）］；与对照组比较，病例组术后深睡眠显著减少［18.3%（4.1%~20.9%）比7.9%（0~11.4%）］（P<0.05），所有患者缺乏快速眼动睡眠（rapid eye movement, REM），72％（36例）患者缺乏慢波睡眠（slow wave sleep, SWS），对照组只有6例缺乏REM，5例缺乏SWS。与对照组比较，病例组的术后睡眠更破碎，夜间睡眠觉醒更频繁［9.1次/h（4.8~24.3次/h）比20.5次/h（8.8~32.2次/h）］（P<0.01）。 结论 术后老年患者容易出现睡眠障碍和睡眠剥夺，表现为睡眠总时间不足、深睡眠缺乏、睡眠破碎、频繁觉醒。
Ｏｂｊｅｃｔｉｖｅ To evaluate the sleep quality and architecture of postoperative elderly patients without mechanical ventilation in surgical intensive care unit(SICU). Methods The polysomnography(PSG) were recorded and analyzed from fifty elderly patients in SICU(case group) and forty non-surgical physical examination elderly(control group) by using Australian Compumedics Siesta. Results Compared control group, the case group had less total sleep time[289.5 min(147.5-398.8 min) vs 218.4 min(125.3-345.7 min)](P<0.05), poor sleep efficiency[48.2%(24.6%-66.5%) vs 36.3%(20.8%-57.6%)](P<0.05). PSG showed that stage-1 sleep was dominant in the case group[67.3%(21.6%-78.3%)] and stage-2 sleep was dominant in control group [59.6%(18.2%-73.2%)]. The case group had less deep sleep than control group[18.3%(4.1%-20.9%) vs 7.9%(0-11.4%)](P<0.05). The postoperative sleep of case group were absent rapid eye movement(REM) and seventy-six percent were absent slow wave sleep(SWS). Meanwhile only six elderly patients had no REM and five elderly had no SWS in control group. The postoperative sleep of case group were more broken and more frequently aroused than control group[9.1 bph(4.8-24.3 bph) vs 20.5 bph(8.8-32.2 bph)](P<0.01). Conclusions Postoperative elderly patients are more vulnerable to sleep disorder and disturbance and shows the significant decrease of total sleep time, absence of deep sleep, fragmented sleep and frequently aroused.
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